You probably have heard about the benefits of breastfeeding for babies, but what about for mothers? How can breastfeeding benefit you and your baby? Suppose you cannot breastfeed for some reason? What then?
Benefits for babies.
Human breasts are designed to produce human milk to feed human babies. Formula manufacturers do their best to replicate human milk, but no other source will give a baby the same degree of benefits. In a baby's earliest days, she absorbs her mother's immunity to diseases through her mother's easily-digested milk. Babies who are nursed have fewer earaches, respiratory illness and diarrhea than bottle-fed babies.
Mother's milk never has a manufacturer's recall, and it costs much, much less than formula. In situations where clean water and proper sanitation are hard to maintain, it is safer. These are some of the factors that have led the American Academy of Pediatrics to recommend that babies be breastfed exclusively for the first six months of their life and that mothers continue to nurse until the baby's first birthday or longer even after other foods are introduced.
Benefits for mothers.
Breastfeeding may help mothers get back to their pre-pregnancy weight and shape faster. It can also reduce breast cancer risk. Many of the factors that affect breast cancer risk are beyond our control. We can't choose our mothers and grandmothers. We can't change our breast density or exposure to radiation or chemicals when we were children. The age at which we have our first child is determined by economic factors, the presence of a dependable partner, and our own fertility more than by a calculation that early childbearing reduces breast cancer risk.
But once we have a baby, we usually have a choice about how we will feed him or her. Knowing that breastfeeding reduces breast cancer risk gives us a tool to help prevent breast cancer. How much will breastfeeding reduce your risk? The exact amount is hard to calculate. One study found that for every 12 months of nursing, breast cancer risk decreased by 4.3% compared to non-nursing women. Other studies have been less conclusive, but most studies find that longer breastfeeding is more protective even when divided over several children. So nursing three children six months each for a total of 18 months may reduce risk more than nursing one child for 12 months. Even if the reduction sounds small, in public health terms it can add up. One study led by Dr. Melissa Bartick estimated that there would be 5,000 fewer breast cancer cases annually in the United States if all mothers followed the recommended guidelines.
Breastfeeding seems to offer more protection against certain types of breast cancer, so perhaps earlier inconclusive studies didn't look at subtypes of cancer when compiling their results. Fortunately, the risk reduction from breastfeeding seems to be most effective against some of the most aggressive forms of the disease such as those with BRCA1 mutations and estrogen receptor (ER) negative tumors.
A recent large study of African-American women found that breastfeeding reduced ER negative and triple negative tumors, but not ER positive ones. These types of tumors are especially aggressive, so it is good to know African-American women now have a way to fight back against the possibility of these dangerous forms of breast cancer.
Breastfeeding during and after breast cancer.
If you have had breast cancer and want to nurse your baby, you will need to discuss the possible hurdles with your doctor. Surgery on the breast with the cancer may reduce your chances of successful feeding on that side depending on the extent of the surgery. Hormonal treatments will probably suppress lactation. In fact, if you are on any drugs like chemo or targeted therapies, you will not be able to nurse because the drugs go into your milk and could harm the baby. However, if you still have a working breast and don't need follow up drugs, you may be able to nurse just fine. If you need a bilateral mastectomy to save your life, being alive to take care of your child for years to come is much more important than breastfeeding.
Other barriers to nursing.
Other types of breast surgery such as implants or a breast reduction may affect your ability to breastfeed. Maybe you need a medication that could harm your baby if it passes through into your milk. Part of the Affordable Care Act mandates a private place and appropriate breaks for mothers to express milk at work; however, this doesn't always work out in practice. Nursing mothers often need to speak up for their rights, but not everyone feels secure enough in her job to do so. Some women have variable schedules or frequent travel that makes breastfeeding impractical. Sometimes the baby has a medical condition that eliminates the possibility of breastfeeding.
If any of these situations apply, you may be relieved to learn about recent research comparing long-term effects on breast and bottle fed babies. Previous research seemed to indicate a clear advantage to the breastfed babies. However, in the United States, women with more education and a higher income are more likely to breast feed, so it is not surprising that their children might have advantages. In the new study, researchers compared siblings, one of whom had breast fed and one who had bottle fed, and looked at them between the ages of 4 and 14. When the factors of education, race, and income were stripped away, so were the long-term advantages of the breast fed babies.
So you needn't feel that you have ruined your baby for life if you cannot nurse. There are clear advantages to both you and your child in the first year of life from breastfeeding. As a society we would all benefit from making family leave policies and work place conditions more friendly for mothers to breastfeed. Nurse if you can. If you can't, be thankful that now we have more than one safe way to feed babies.
American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Policy Statement. Pediatrics. 2013. Accessed from http://pediatrics.aappublications.org/content/129/3/e827.full.html Nov. 8, 2014.
Azvolinsky, A. Breastfeeding Reduces Breast Cancer Risk in Black Women. Cancernetwork. Oncology. September 25, 2014. Accessed from http://www.cancernetwork.com/triple-negative-breast-cancer/breastfeeding-reduces-breast-cancer-risk-black-women?GUID=E516FC5C-7604-40FE-85E6-8F7CE4923438&XGUID=&rememberme=1&ts=26092014 Nov. 7, 2014.
Colen, C. and D. Ramey. Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons. Social Science & Medicine. May 2014. Accessed from http://www.sciencedirect.com/science/article/pii/S0277953614000549 Nov. 8, 2014.
Rochman, B. More Breast-Feeding Could Save Billions and Prevent Thousands of Breast Cancer Cases. Time. June 7, 2014. Accessed from http://healthland.time.com/2013/06/07/more-breast-feeding-could-save-billions-and-prevent-thousands-of-breast-cancer-cases/ Nov. 7, 2014.
Saslow, D. Can breastfeeding lower breast cancer risk? Expert Voices. American Cancer Society. May 7, 2013. Accessed from http://www.cancer.org/cancer/news/expertvoices/post/2013/05/07/can-breastfeeding-lower-breast-cancer-risk.aspx Nov. 7, 2014.